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Prioritisation of surgery for pituitary tumours

This study is based on the findings of internationally renowned skull base surgeons who convened to recommend this stratification scheme. The study authors report that incidental diagnosis of pituitary tumours during routine imaging as well as early identification of visual...

Close monitoring of patients for delayed hyponatremia post-transsphenoidal surgery

he incidence of delayed hyponatremia is 16-28% and usually accounts for unplanned readmission of the patient within 30 days after transsphenoidal surgery. One of the surrogate measures of quality of care adopted by the government and regulatory agencies is 30-day...

Preserving hearing in NF2 patients

Neurofibromatosis type 2 (NF2) is known to result in bilateral hearing loss, even when there is no significant tumour growth. The cause is postulated to be multifactorial: stretching and compression of the cochlear nerve by the tumour, impairment of labyrinthine...

A new bio-glue for neurosurgical wound closures

Dural closures need to be tight to prevent cerebrospinal fluid leaks. Traditional wound closure techniques involve sutures and DuraSeal which is the only FDA approved polyglycol hydrogel sealant with proven safety and efficacy profile. This article describes a new sealant,...

Do endonasal approaches for meningiomas have more CSF leaks?

Rarely, patients presenting to the ENT surgeon with anosmia may have an anterior skull base neoplasm such as a meningioma. Historically, the traditional approaches have focused on several transcranial, external routes, including the pterional craniotomy, and the subfrontal craniotomy. The...

Delayed facial palsy post vestibular schwannoma resection

This article presents findings of a retrospective evaluation of 489 patients who underwent vestibular schwannoma surgery and developed delayed facial palsy. The authors define delayed facial palsy as deterioration of at least two HB grades between postoperative days five and...

Pituitary tumour associated headaches

This longitudinal cohort study presents data with significant clinical implications for patients with headaches and the clinicians and surgeons who treat them. For the study, patients completed a self-administered survey on headache characteristics on initial presentation and after surgery of...

Novel balloon device to control cavernous sinus bleeding

In their Letter to the Editor, the authors suggest a draft for a novel balloon catheter device for sinus haemostasis during trans-sphenoidal surgery which is associated with uncontrollable sinus bleeding in 1-8% cases. Their proposed device has a single lumen...

Reducing readmission rates after transsphenoidal pituitary surgery

This retrospective study provides an outpatient care pathway to screen and manage delayed hyponatremia which the study identified as the primary cause of readmission following transsphenoidal pituitary surgery. Of the 303 patients who were studied, 27 were readmitted within 30...

The increasingly favourable outcomes from endoscopic endonasal approaches for the management of pituitary adenomas

Historically, pituitary tumours have been surgically managed with an open, transcranial approach. Although this approach still has its merits in large intracranial adenomas, technological advancement has allowed smaller tumours to be debulked via a transseptal microscopic technique. These days, the...

Endoscope assisted removal of jugular foramen schwannomas

This article, written by a renowned surgeon with extensive experience in removal of jugular foramen and skull base lesions, describes a new classification for jugular foramen schwannomas (JFS) and a template for selection of surgical approach for endoscope assisted removal....

How should I excise sinonasal tumours, open or endoscopic? En bloc or piecemeal?

Sinonasal tumours often present late because initial symptoms mimic benign disease. They tend to produce more unilateral nasal symptoms, and patients with advance disease often describe paraesthesia and other cranial neuropathies. They only account for approximately 3% of upper aerodigestive...